Cost effectiveness of disulfiram

Abstract

Converging evidence suggests that disulfiram is a promising treatment for cocaine dependence. We study the cost-effectiveness of providing disulfiram to methadone-maintained opioid addicts in a randomized clinical trial setting. Our economic evaluation is based on a double blind clinical trial in which 67 cocaine-dependent methadone-maintained opioid-dependent subjects were randomized to get the additional treatment of disulfiram or placebo in a 12-week trial.Outcome measures used are the number of days of cocaine use and grams of cocaine per week. Cost measures used are the cost of providing standard methadone treatment and the incremental cost of adding disulfiram to the standard treatment. Cost measures of standard and disulfiramenhanced treatment were collected retrospectively from the provider.Results from this cost-effectiveness analysis imply that, even though disulfiram increases slightly the cost of methadone treatment, its increase in effectiveness may be important enough to warrant its addition for treating cocaine dependence in methadone-maintained opiate addicts.

Disulfiram, an old drug with new potential therapeutic uses for human cancers and fungal infections

“…38 Moreover, disulfiram is finding increasing use in cocaine addiction. [39][40][41] There are several excellent reviews on the use of disulfiram in narcotic addiction and due to space constraints this aspect will not be addressed here.…”

Cost-Effectiveness of Peer-Delivered Interventions for Cocaine and Alcohol Abuse among Women: A Randomized Controlled Trial

“…For non-abstinence outcomes, Zarkin et al [13] determined that medical management combined with either naltrexone or naltrexone and acamprosate was cost-effective in avoiding heavy drinking (using the same heavy drinking definition as ours), with ICERs of $2,847 and $8,095. Jofre-Bonet et al [38] examined the cost-effectiveness of disulfiram in addition to methadone maintenance for treating cocaine dependence, yielding an incremental cost of $73 per day of cocaine reduced.…”